| Psy-med, Inc. | |
|
8140 Walnut Hill Lane Suite 308 Dallas TX 75231-4396 | |
| (214) 348-5557 | |
| (214) 348-5898 |
| Full Name | Psy-med, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 8140 Walnut Hill Lane, Dallas, Texas |
| Authorized Official Name and Position | Dwayne Anthony Guccione (CEO) |
| Authorized Official Contact | 2143485557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psy-med, Inc. 8140 Walnut Hill Lane Suite 308 Dallas TX 75231-4396 Ph: (214) 348-5557 | Psy-med, Inc. 8140 Walnut Hill Lane Suite 308 Dallas TX 75231-4396 Ph: (214) 348-5557 |
| NPI Number | 1881842102 |
|---|---|
| Provider Enumeration Date | 08/28/2008 |
| Last Update Date | 01/27/2015 |
| Medicare PECOS PAC ID | 5092863662 |
|---|---|
| Medicare Enrollment ID | O20090508000408 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881842102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0004X | Psychologist - Health | (* (Not Available)) | Primary |
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
| Provider Name | Antonia W Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750500856 PECOS PAC ID: 0941283980 Enrollment ID: I20040610000622 |
| Provider Name | Alison J Glezen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669429494 PECOS PAC ID: 9638167554 Enrollment ID: I20050221000600 |
| Provider Name | Shawanda A Williams Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831257492 PECOS PAC ID: 6406922830 Enrollment ID: I20080908000509 |
| Provider Name | Constance Cox |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235373226 PECOS PAC ID: 8022160613 Enrollment ID: I20090713000207 |
| Provider Name | Paula Ann Moore Wilson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770734006 PECOS PAC ID: 0143407940 Enrollment ID: I20110603000270 |
| Provider Name | Amanda G Glover |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922395730 PECOS PAC ID: 5496920084 Enrollment ID: I20111209000330 |
| Provider Name | Venette C Westhoven |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104995547 PECOS PAC ID: 9931201977 Enrollment ID: I20130404000382 |
| Provider Name | Rosslyn K Douglas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437492311 PECOS PAC ID: 9830323658 Enrollment ID: I20131010001320 |
| Provider Name | Ericka Ann Brothers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598183824 PECOS PAC ID: 2365665270 Enrollment ID: I20140522000478 |
| Provider Name | Heather L Parton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134533359 PECOS PAC ID: 7719104488 Enrollment ID: I20140805000509 |
| Provider Name | David Michael Latini |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932404464 PECOS PAC ID: 4284916115 Enrollment ID: I20170128000009 |
| Provider Name | Sandra Cordova |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801275177 PECOS PAC ID: 2264709930 Enrollment ID: I20170531000546 |
| Provider Name | Liliana Haenner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902308927 PECOS PAC ID: 3476815101 Enrollment ID: I20180316001904 |
| Provider Name | Erin Griffith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1699241075 PECOS PAC ID: 4880939636 Enrollment ID: I20181222000124 |
| Provider Name | Larry Wayne Carter |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477834133 PECOS PAC ID: 1153755756 Enrollment ID: I20200107000025 |
| Provider Name | John K Kreymer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679689236 PECOS PAC ID: 0345152583 Enrollment ID: I20220622001449 |
| Provider Name | Darlene Broussard Witcher |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760598346 PECOS PAC ID: 4082060074 Enrollment ID: I20231027000142 |
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